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Michael Larkin - Queens Group, LLC �6O Lo l 1 rX15 Ave., • • RECEIVED Office of the City Clerk MAR 12 2020 1700 Convention Center Drive • Miami Beach, FL 33139 CITY OF MIAMI BEACH . 305:673.7411 OFFICE OF THE CITY CLERK • • LOBBYIST REGISTRATION FORM - Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat cc modification of any ordinance; resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any City board'or committee;or any.action,.decision or recommendation of any City.personnel during the time period of the • entire decision-making process on-such action, decision or recommendation that foreseeably will be heard or reviewed by the City commission, or a City board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists"has specific exclusions. Please refer to City Code Chapter 2, Article VII, Division 3, entitled 'Lobbyists,". for additional information. Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee, to the Office of the City 'Clerk. If you need more space to complete an answer, use a separate sheet(s)of paper. If you have,nothing to report in a particular - section, you must write "none" or "n/a" in that section. Any change to any information originally.filed, or any additional City Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Larkin Michael NAME OF LOBBYIST - (Last) (First) ' (Middle Name) • Bercow Radell Fernandez Larkin&Tapanes, PLLC 200 South Biscayne Blvd., Ste. 850 Miami, Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5300 mlarkin©brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL'INFORMATION: Viso Christopher NAME OF PRINCIPAL (Last) (First) (Middle.Name) Queens Group, LLC 860 Collins Avenue Miami Beach Florida 33139 • PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) • (305) 800-0805 chris©queenshospitality.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS • ursuant'DM Code Section 2 482(h)(1)(a) principal ofQecorporation, partnership,@j'otherj4 (gipappears ma lobbyist a behalf Of(k EMU,without special compensation C?reimbursement for lit)appearance,whether direct,indirect, 'contingent, to GED32§11i suo oort @ (7 oo position +o . Sa tOES f+)the( 3fl .rep fired EV(lb subsection'butshall!IRMO reoLifted t I 7eThWreeistration ,• • If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section.2-482(c): • • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY(if none,write NIA):_ Christopher Viso • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST(if none;write N/A): See Attached. • Page 'I of 5 • Act- III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid, or public hearing number: Development Approvals.&Planning Issues,including but not limited to the Historic Preservation Board, Design Review Board,Planning Board, Board of Adjustment, Land Use Development, City Commission, and any City Workshops or Committees,if necessary,relating to the property located at 860 Collins Avenue in Miami.Beach,.Florida.. IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to.City Code Section-2-482(a)(4), list the City Commissioner or City personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said City Commissioner or City personnel from 12 months preceding suchcommencement of service with the City to the present date,stating the general nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship (If yes;explain) YES NO Title of Person to be Lobbied Staff for the Planning&Building Department . None X. Public Works& City Administration, PB, HPB,BOA None X DRB, City Commission,and Mayoras necessary None • X Pursuant to City Code Section 2-482(g), every registrant shall berequired to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety,with any current City Commissioner or City personnel who is sought to be lobbied as identified on the lobbyist registration form filed. List:any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): None V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fee is prohibited pursuant to City.Code Sec. 2-485.3): . $675.00 per.hour Page 2 of 5 The following six(6)questions MUST be answered: • 1) Pursuant to City Code Section 2-488, entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes xNo: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods, equipment or service? 2). Pursuant to City.Code Section 2-490,entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes_x No: Are you lobbying on a pending application for a Development Agreement with the City or application for changeof zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of"lobbyist"-as set forth in Section 2-481)who only appears as a representative of a not-for-profit corporation orentity without special compensation or reimbursement for the appearance,whether direct or indirect to express support of or opposition to any item, shall register with thecity clerk as required by this section, but shall not be required to pay any registration fees. _Yes xNo: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who provide only scientific, technical or other specialized information or testimony in public meetings;.any person who only appears. as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent, to express support of or opposition to any item;and any person who only appears as a.representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement forthe appearance. YesxNo: Are you providing only scientific, technical or other specialized information; appearing as a _ _ representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services within the past election cycle.See Section 2-491 for more information. Yes xNo: Have youprovided campaign consulting services to an incumbent member of the City Commission within the past election:cycle?If yes, please list the incumbent member(s)of the City Commission: Yes xNo. If es has it been less than 1r2 months since the elected officials whom -au +rovided cam ai,n consulting services was sworn in. 6) Pursuant to City Code Section 2-482(a)(4)a.,.a lobbyist whohas within the past election cycle provided campaign consulting services toan incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. Yes xNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: Yes xNo: . If yes,b were'yrou promised°or did,you receive economic consideration in exchange for-campaign — — consulting services . TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes No Amount Paid$ /► °MCR# "2�7(' / Date Paid 3 Lobbyist Registration Form received and verified by: lC� t J /-j 5 F:\CLER\$RLL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-2045 REG doc Revised 09/20/2018 Page 3of5 . VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.'Signature of Lobbyist: .. Date 3116/Zo?i0 I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct, and that I have read or am familiar with the provisions contained in Chapter 2, Art.VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and .11 rep► ‘g requirements. _ 5)P/two o Signature of Lobbyist: Date Signature of Principal: _ Date 3/10 ida 0 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL flDit � . State of n ;� p State of F 1 n 4J County of: \J a M t —lag, County of: N1+�wt► 1b,a o Sworn to(or affirme }and subscribed before me Sworn to(or affirmed) and subscribed before me this 10 day of MATCh ,2IA, by this 14 ,day of rtn4i,GL ,2O by Michael W. Larkin (,'k r%S-1-0 p\-4.-,r kits O NAME OF LOBBYIST NAME OF PRINCIPAL _Produced I I _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION X Person:IL; • n LPersonally K • • 11` / � Signature of N.+t Pu -c Sig Orr otary Public Dtth% M0-C Te�ve. v, ,•11* Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped ` ` YPL4. Dus, DIANA ,IEEvMwtuff (NOTA'l 4,t$'' I_,_ MY COMMISSION#GG 308355 (N ' ' • .c'MyCOMMISSION#GG300870 1.:.^..,••-&.:41 EXPIRES:April 10,2023 's"�. .47,r' EXPIRES:April 29,2023 ''3:'oF f0- Bonded Thru Notary Public Underwr#ers '4411.6,• Bonded TIN Notary Public Undem,1tela J l �r ♦r=r�rr I The term "lobbyist"specifically excludes the following persons: Expert witnesses who provide only scientific, technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 1 �Py I'll 14y 4ko(} 0,1 IL= s - r ll City of Miami Beach, I/UU Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411, Fax:305.673 7254 NAME OF LOBBYIST: Micheal W. Larkin 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principal)who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penalties that may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th of each year, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which I have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-month period commencing October 1 of each year, and the fee for such annual registration shall be $500.00 pursuant to Section 2-482 of the Miami Beach City Code. 3))11)0-dab Signature of Lobbyist Date FACLERSALLIaFORMS4LOBBYIST FORMSILabbyist Registration Form Revised 09-20-1SREG.doe Page 5 of 5 Electronic Articles of Organization FILED 60008 00 64 AM For September 28, 2016 Florida Limited Liability Company Sec. Of State sgilbert Article I The name of the Limited Liability Company is: QUEENS GROUP, LLC Article II The street address of the principal office of the Limited Liability Company is: 860 COLLINS AVENUE MIAMI BEACH, FL. 33139 The mailing address of the Limited Liability Company is: 860 COLLINS AVENUE MIAMI BEACH, FL. 33139 Article III The name and Florida street address of the registered agent is: CHRISTOPHER VISO 860 COLLINS AVENUE MIAMI BEACH, FL. 33139 Having been named as registered agent and to accept service of process for the above stated limited liability company at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: CHRISTOPHER VISO Article IV L16000180964 FILEDThe name and address of person(s) authorized to manage LLC: September 0 AM p � ) g 28, 2016 Title: MGR Sec. Of State CHRISTOPHER VISO sgilbert 860 COLLINS AVENUE MIAMI BEACH, FL. 33139 Title: MGR CHARLES SCHNEIDER 860 COLLINS AVENUE MIAMI BEACH, FL. 33139 Signature of member or an authorized representative Electronic Signature: CHRISTOPHER VISO I am the member or authorized representative submitting these Articles of Organization and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report between January.1st and May 1st in the calendar year following formation of the LLC and every year thereafter to maintain "active" status. : MBF City Hall --, - i 700 Converit ion Center Br. Miami Beach , FL 33139 305.-673-7420 i , o L.'. - Welcome c , V. (--.., -, 004411-0006 Adrian V 03/12/2020 09:02AM ': _ f••• k ' '' ',.....„, r-s':% IL ty ;,----, ,_ 'U -S--- 0 -\ MISCELLANEOUS .1 1 '' \-„,„.‘- ",... ,.,-1 0 -/ , . , - o .- -' Description: MCR OPEN : d •1/4... - ,,. , \ 69. c---- '--_ 1,„ :„.: 0 .1_ (MGR) .. -;,, A-- Reference 1; MCR425761 NCR OPEN (NCR) 2020 Item: MCR 1 @ 700.00 r n-- MCR OPEN (MCR) 700.00 , ,.. ''' f---N .--,-- :„ - 700.00 1- r-- --,,,,- ---„,.., ,--- - . I Subtotal 700.00 , 1 - - .--_ \"'. - .- Total 700.00 CHECK 350.00 Check Number001379 CHECK 350.00 Check Number001300 ,o3 7, I-. Change due 0.00 ..cz co r = X ta \-,-- . E • N. -• V. 0 ° ...t. 3--.„ ,..--, ,......' Paid by: QUEENS HOSPITALITY CORP. '6. Et I" ' _ f.D. ' ° •°;:`,I,' c ti 2, '..--). .' 2 --:—.,‘ ENNIEN1181111111111H11111111111 1-,,, . 0 - 0 -,,,--- ,.., ,-. . = -,,s H (13 u. ..c v. p, 1811 :: ti z Z 716,0 2 ( `.---ti ...Ili- 0 utag 0,1" W 11.5 y 1g .'. 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